with dual targeting or even 3,4,5 targets in the one injection, Claritys bis PSMA is under threat before it has even hit the marketYou make many erroneous judgements Nathan.
Clarity's bisPSMA will only come under threat AFTER it has displaced Telix's Illuccix. That has not happened YET, so I think going beyond is jumping too many steps.
Anyhow though, you need to look at how this improvement from the so called 'dual targeting' (as described in that paper) comes about. Its dependent on the proteins expressed (the targets) on the cancer cell. PSMA and GRPr combined already account for the vast majority of Prostate Cancers. So, by adding a 3rd tracer to the mix, the gains will likely be minimal, if any (coz there is nowhere to go once you hit 100%). So, who is going to use 3, 4, or 5 targets, when you can achieve the same with 1 or 2 at most? Remember, the two used, at 75% Sensitivity, still looks inferior to Clarity's single tracer 64Cu-Sar-bisPSMA. As I said, what they added in that study, is an equivalent of 64Cu-Sar-BOMBESIN, so your suggestion to increase to 3 may still not surpass just these 2 from Clarity.
Cost (you will need 3, 4, or 5 injections, and the equivalent number of scans), and exposure to radiation. This is not a race to the moon, or mars: its diagnosing and treating cancer.
Mixing 3, 4, or 5 targets in one injection? I suspect the whole body will light up due to the offsite uptake!
On the same subject, there are other approaches, such as targeting the Cancer Cell environment. That's where FAP comes in: Clarity have one for that; 64/67Cu-Sar-FAP.
There is pre-targeting as well - Clarity have one! Read it up - pretty exciting.
https://www.claritypharmaceuticals.com/news/pre-targeting/
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